Scoliosis Diagnosis and Treatment Should Be Anything But Generic
Idiopathic Scoliosis is often categorized by a patients x-ray evaluation and a number called Cobb's angle.
I often hear parents explain their child's situation by simply stating "my child has scoliosis".
As a clinician who works with natural methods to reduce and stabilize scoliosis, I often wonder why the medical community creates such a generic approach to educating parents.
The diagnosis is scoliosis and the recommendation is either, watching it, bracing it, or fusing it entirely based on a number.
I find this interesting merely based on the over simplification involved with this process.
I am writing this brief article to inform parents that they need to understand that not every kid with scoliosis is the same.
There are numerous factors that are involved with not only diagnosing this condition, but in actually treating it.
The first piece of information that is relevant to understanding this condition is a person's age at diagnosis and currently.
Age is a crucial factor in determining progressive risk and options available to aid in understanding their condition.
For instance, Scoliscore is a wonderful genetic test that is simple to perform and gives the clinician and parents insight into the future, especially if the spinal curvature is currently less that 30 degrees, but it is only available if the patient is at least 9 but not yet skeletally mature.
If this test is available and your child is within testable parameters, then get the test.
If 75% of kids tested with Scoliscore are in a mild range of genetic risk and your child is in this group, then you can quickly rule out a rigid brace as the brace is designed to halt progression and avoid surgery.
A mild genetic score means your child's scoliosis won't reach surgical threshold so therefore no need to put them through this agonizing brace protocol, I say agonizing because just imagine yourself being squeezed into a plastic brace that reduces your breathing capacity by 30% for 20+ hours a day for years, not to mention the added pressure of being different in today's highly competitive and harsh social climate among young teens.
Another important factor about age is based on the fact that nearly 70% of all progression occurs in a 30 month time frame during pubertal growth, 11-14 in females and 13-16 in males.
If your child is diagnosed with a moderate curvature of greater than 25 degrees and they have not entered pubertal growth, their condition is likely to deteriorate quickly as they enter this phase of growth.
If your child has a scoliosis that is less than 50 degrees and they are past their pubertal growth cycle than the progression is likely to slow dramatically or even stop completely.
The second valuable piece of information a parent should acquire is their child's curve pattern or type.
There are 4 primary curve patterns, thoracic primary (60%), thoracolumbar (25%), double major(10%), and lumbar primary (5%).
This information is crucial in understanding the mechanics and often is a major factor in how treatment is performed and how likely they are to respond to treatments like exercise, bracing, and even surgery.
The curve type should also include gravitational alignment, number of vertebrae that are involved in creating the Cobb's angle, the amount of rotation at the curves apex, and how much compensation is present.
In addition relevant changes in the sagital (side view) should be determined as pulmonary compromise often occurs only when both thoracic primary curves exceed 60 degrees and the thoracic spine moves anterior.
So if your child has a thoracolumbar, lumbar curve, or thoracic primary in the absence of anterior displacement then respiratory compromise is unlikely.
If your child has lumbar spine involvement and fusion is performed, the level of permanent impairment increases as well as the likelihood of hardware failure and future side effects.
In the event that your child has a high thoracic primary with heavy rotation and a low vertebrae count, the effectiveness of rigid bracing with this curve pattern will essentially eliminate this choice.
So you can start to see the importance of knowing more than just they have it and a number.
Understanding your child's scoliosis, treatment options, and the effectiveness of those options, starts with a good clinician who spends the time to properly inform you about your child's spinal condition.
It's also time for doctors and paraprofessionals to stop scaring parents and children with ridiculous scenarios of impending poor health and even death if a mature teen with a 40-70 degree scoliosis that is not fused, pure nonsense.
Let's get the facts, analyze them, determine what is truly in the best interest of your child, and stop oversimplifying their condition in order to limit a child's options.
Here's a short list of relative information that should be gathered when your child is diagnosed with scoliosis.
Current Age Age at First Diagnosis Gender Age of First Mensus (Females) Genetic Predisposition (Scoliscore) Neurotransmitter Profile Type of Curve Number of Vertebrae in Primary Curve Degree of Rotation at Apex Gravitational Alignment Compensation Sagital Spine Changes Respiratory Capacity (Primary Thoracic Curves) Global Posture Assessment Sensory Integration Tests (Balance, Proprioception) Symptoms Underlying Health Conditions Fitness Level MRI (Left Thoracic Curve or High Thoracic)
I often hear parents explain their child's situation by simply stating "my child has scoliosis".
As a clinician who works with natural methods to reduce and stabilize scoliosis, I often wonder why the medical community creates such a generic approach to educating parents.
The diagnosis is scoliosis and the recommendation is either, watching it, bracing it, or fusing it entirely based on a number.
I find this interesting merely based on the over simplification involved with this process.
I am writing this brief article to inform parents that they need to understand that not every kid with scoliosis is the same.
There are numerous factors that are involved with not only diagnosing this condition, but in actually treating it.
The first piece of information that is relevant to understanding this condition is a person's age at diagnosis and currently.
Age is a crucial factor in determining progressive risk and options available to aid in understanding their condition.
For instance, Scoliscore is a wonderful genetic test that is simple to perform and gives the clinician and parents insight into the future, especially if the spinal curvature is currently less that 30 degrees, but it is only available if the patient is at least 9 but not yet skeletally mature.
If this test is available and your child is within testable parameters, then get the test.
If 75% of kids tested with Scoliscore are in a mild range of genetic risk and your child is in this group, then you can quickly rule out a rigid brace as the brace is designed to halt progression and avoid surgery.
A mild genetic score means your child's scoliosis won't reach surgical threshold so therefore no need to put them through this agonizing brace protocol, I say agonizing because just imagine yourself being squeezed into a plastic brace that reduces your breathing capacity by 30% for 20+ hours a day for years, not to mention the added pressure of being different in today's highly competitive and harsh social climate among young teens.
Another important factor about age is based on the fact that nearly 70% of all progression occurs in a 30 month time frame during pubertal growth, 11-14 in females and 13-16 in males.
If your child is diagnosed with a moderate curvature of greater than 25 degrees and they have not entered pubertal growth, their condition is likely to deteriorate quickly as they enter this phase of growth.
If your child has a scoliosis that is less than 50 degrees and they are past their pubertal growth cycle than the progression is likely to slow dramatically or even stop completely.
The second valuable piece of information a parent should acquire is their child's curve pattern or type.
There are 4 primary curve patterns, thoracic primary (60%), thoracolumbar (25%), double major(10%), and lumbar primary (5%).
This information is crucial in understanding the mechanics and often is a major factor in how treatment is performed and how likely they are to respond to treatments like exercise, bracing, and even surgery.
The curve type should also include gravitational alignment, number of vertebrae that are involved in creating the Cobb's angle, the amount of rotation at the curves apex, and how much compensation is present.
In addition relevant changes in the sagital (side view) should be determined as pulmonary compromise often occurs only when both thoracic primary curves exceed 60 degrees and the thoracic spine moves anterior.
So if your child has a thoracolumbar, lumbar curve, or thoracic primary in the absence of anterior displacement then respiratory compromise is unlikely.
If your child has lumbar spine involvement and fusion is performed, the level of permanent impairment increases as well as the likelihood of hardware failure and future side effects.
In the event that your child has a high thoracic primary with heavy rotation and a low vertebrae count, the effectiveness of rigid bracing with this curve pattern will essentially eliminate this choice.
So you can start to see the importance of knowing more than just they have it and a number.
Understanding your child's scoliosis, treatment options, and the effectiveness of those options, starts with a good clinician who spends the time to properly inform you about your child's spinal condition.
It's also time for doctors and paraprofessionals to stop scaring parents and children with ridiculous scenarios of impending poor health and even death if a mature teen with a 40-70 degree scoliosis that is not fused, pure nonsense.
Let's get the facts, analyze them, determine what is truly in the best interest of your child, and stop oversimplifying their condition in order to limit a child's options.
Here's a short list of relative information that should be gathered when your child is diagnosed with scoliosis.
Current Age Age at First Diagnosis Gender Age of First Mensus (Females) Genetic Predisposition (Scoliscore) Neurotransmitter Profile Type of Curve Number of Vertebrae in Primary Curve Degree of Rotation at Apex Gravitational Alignment Compensation Sagital Spine Changes Respiratory Capacity (Primary Thoracic Curves) Global Posture Assessment Sensory Integration Tests (Balance, Proprioception) Symptoms Underlying Health Conditions Fitness Level MRI (Left Thoracic Curve or High Thoracic)
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